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Summaries for Patients|20 November 2001

Doctors' Willingness To Participate in the Death Penalty

The summary below is from the full report titled “Physicians' Willingness To Participate in the Process of Lethal Injection for Capital Punishment.” It is in the 20 November 2001 issue of Annals of Internal Medicine (volume 135, pages 884–888). The authors are NJ Farber, BM Aboff, J Weiner, EB Davis, EG Boyer, and PA Ubel.

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What is the problem and what is known about it so far?

In the United States, some states require a doctor's involvement when lethal injections are given for the purposes of capital punishment (death penalty). However, major medical societies, such as the American Medical Association (AMA), believe that doctors should not participate in the death penalty. In a recent survey, most doctors said that it was acceptable for their colleagues to participate in the death penalty. However, it is not known whether doctors themselves would personally participate.

Why did the researchers do this particular study?

To explore if and why doctors are willing to be involved in carrying out the death penalty.

Who was studied?

1000 practicing doctors selected at random from an AMA list of doctors in the United States. Not all of the doctors were members of the AMA.

How was the study done?

The researchers mailed a survey to the 1000 doctors selected from the AMA list. The survey asked the doctors about themselves and their attitudes toward the death penalty. The survey also asked the doctors whether they would be willing to do each of the following 10 things: select injection sites, start intravenous lines for lethal injection, give the injection, monitor the prisoner during the injection, pronounce the prisoner dead, inspect the injection devices, supervise lethal injection personnel, order the drugs used in lethal injection for the prison pharmacy, prescribe tranquilizers for the prisoner the night before the execution, and sign the death certificate. They then calculated how often doctors were willing to do the first eight of these activities, which are prohibited by the AMA.

What did the researchers find?

Of the 1000 doctors who were mailed a survey, 962 received it and 413 completed it. Of the responding doctors, 19% said they would be willing to actually give the lethal injection and 36% said they would be willing to pronounce the prisoner dead. Forty-one percent of the doctors would do at least one of the AMA-prohibited actions, 25% would do five or more, and 14% were willing to perform all eight prohibited actions. Not surprisingly, doctors in favor of the death penalty or those who perceived a duty to society were most willing to participate in the death penalty. Very few of the doctors knew of the AMA policy on participating in the death penalty.

What were the limitations of the study?

Fewer than half of the surveyed doctors completed the survey. The doctors who answered the survey might not represent U.S. doctors as a whole. It is unknown whether the doctors would actually do what they said they would do.

What are the implications of the study?

Despite medical societies' policies against doctors' involvement in the death penalty, many physicians would be willing to participate. The medical profession needs to learn more about the ethical issues surrounding doctor participation in the death penalty.

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